Q&A on infection prevention and control for health care work
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Q&A on Infection Prevention & Control by WHO

For health care workers treating COVID-19 patients


The recent outbreak of Coronavirus has left everyone anxious about their safety. With the amount of misinformation out there, it has been difficult to figure out which one to heed to and which one to avoid. Our aim in writing this blog is to help you be aware of the right facts about Coronavirus and take the necessary steps to prevent infection.

 

Q) How can you clean soiled bedding, towels and linens from patients with COVID-19?

A) All individuals dealing with soiled bedding, towels and clothes from patients with COVID-19 should: 

~ Wear appropriate personal protective equipment, which includes heavy duty gloves, mask, eye protection (face shield/goggles), long-sleeved gown, apron (if gown is not fluid resistant), boots or closed shoes before touching any soiled linen. 

~ Never carry soiled linen against body; place soiled linen in a clearly labelled, leak-proof container (e.g. bag, bucket)

~ If there is any solid excrement on the linen, such as feces or vomit, scrape it off carefully with a flat, firm object and put it in the commode or designated toilet/latrine before putting linen in the designated container. If the latrine is not in the same room as the patient, place soiled excrement in covered bucket to dispose of in the toilet or latrine;

~ Wash and disinfect linen: washing by machine with warm water (60-90°C) and laundry detergent is recommended for cleaning and disinfection of linens. If machine washing is not possible, linen can be soaked in hot water and soap in a large drum, using a stick to stir, avoiding splashing. If hot water not available, soak linen in 0.05% chlorine for approximately 30 minutes.  Finally, rinse with clean water and let linen dry fully in the sunlight.

Q) What personal protective equipment (PPE) should be used by healthcare workers (HCW) performing nasopharyngeal (NP) or oropharyngeal (OP) swabs on patients with suspected or confirmed COVID-19?

A) Health care workers collecting NP and OP swab specimens from suspected or confirmed COVID-19 patients should be well-trained on the procedure and should wear a clean, non-sterile, long-sleeve gown, a medical mask, eye protection (i.e., googles or face shield), and gloves. Procedure should be conducted in a separate/isolation room, and during NP specimen collection health care workers should request the patients to cover their mouth with a medical mask or tissue. Although collection of NP and OP swabs have the potential to induce fits of coughing from the patient undergoing the procedure, there is no currently available evidence that cough generated via NP/OP specimen collection leads to increased risk of COVID-19 transmission via aerosols.

Q) Why does WHO recommend contact and droplet precautions and not routine use of airborne precautions for healthcare workers providing care to patients with suspected/confirmed 2019-nCoV infection?

A) WHO developed its rapid guidance based on the consensus of international experts who considered the currently available evidence on the modes of transmission of 2019-nCoV. This evidence demonstrates viral transmission by droplets and contact with contaminated surfaces of equipment; it does not support routine airborne transmission. Airborne transmission may happen, as has been shown with other viral respiratory diseases, during aerosol-generating procedures (e.g., tracheal intubation, bronchoscopy), thus WHO recommends airborne precautions for these procedures.

Q) Can patients with suspected and confirmed nCoV infection be cohorted in the same room?

A) Ideally, suspected and confirmed 2019-nCoV acute respiratory disease patients should be isolated in single rooms. However, when this is not feasible (e.g., limited number of single rooms), cohorting is an acceptable option. Some patients with suspected 2019-nCoV infection may actually have other respiratory illnesses, hence they must be cohorted separately from patients with confirmed 2019-nCoV infection. A minimum of 1-meter distance between beds should be maintained at all times. 

Q) Is there a model for setting up an isolation ward and types and products and health requirements?

A) A model for setting up an isolation ward is currently under development. PPE specifications for healthcare workers caring for nCoV patients can be found  in the disease commodity package at: Click here to read more

Q) What are the disinfectants recommended for environmental cleaning in healthcare facilities or homes housing patients with suspected or confirmed 2019-nCoV infection?

A) Environmental cleaning in healthcare facilities or homes housing patients with suspected or confirmed 2019-nCoV infection should use disinfectants that are active against enveloped viruses, such as 2019-nCoV and other coronaviruses. There are many disinfectants, including commonly used hospital disinfectants, that are active against enveloped viruses. Currently WHO recommendations include the use of:

~ 70% Ethyl alcohol to disinfect reusable dedicated equipment (e.g., thermometers) between uses

~ Sodium hypochlorite at 0.5% (equivalent 5000ppm) for disinfection of frequently touched surfaces in homes or healthcare facilities

 

References:

1. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected: Know more..

2. Health workers exposure risk assessment and management in the context of COVID-19 virus: Know more..

3. Rational use of personal protective equipment for coronavirus disease (COVID-19): Know more..

About Author
Dr. Kinjal Purohit
Kinjal Purohit is a part of the Editorial Team at PlexusMD. She is always ready to learn new things and explore when the opportunity presents itself. When not working either she is binge watching or sleeping.
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S S and 17 others like this13 shares
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Dr. U●●●n D●●●v
Dr. U●●●n D●●●v Internal Medicine
Are there any guidelines as suggested by you that one may keep suspected and proven cases of Covid in the same room.
May 3, 2020Like1
Dr. S●●●●d N●●●u
Dr. S●●●●d N●●●u General Medicine
Please tell me that on vegetables that we buys from local vendors which recieves it from other state mandies is safe from coronovirus or not.
May 4, 2020Like1
N●●a R●●●●●r
N●●a R●●●●●r General Management
Hi Dr Dhruv! You may refer following link for info shared by WHO: https://www.who.int/news-room/q-a-detail/q-a-on-infection-prevention-and-control-for-health-care-workers-caring-for-patients-with-suspected-or-confirmed-2019-ncov
May 5, 2020Like1